Improvement of hand hygiene adherence among staff in long-term care facilities for elderly in Japan

• Published in: Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy Vol. 27; no. 2; pp. 329 - 335
• Main Authors: Sasahara, Teppei, Kosami, Koki, Yoshimura, Akio, Ae, Ryusuke, Akine, Dai, Ogawa, Masanori, Morisawa, Yuji
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 01.02.2021
• Subjects: Hand hygiene; Hand hygiene adherence rate; Hand hygiene promotion program; Long -term care facilities for elderly; Hand hygiene promotion program; Long -term care facilities for elderly; Hand hygiene; Hand hygiene adherence rate; LTCFEs
• ISSN: 1341-321X; 1437-7780
• DOI: 10.1016/j.jiac.2020.12.002

Hand hygiene is crucial for infection control in long-term care facilities for elderly (LTCFEs), because it can be easily implemented in the low-resource settings of LTCFEs. This study investigated the actual status of hand hygiene adherence in LTCFEs, identified the factors inhibiting its appropriate implementation, and evaluated the effectiveness of a hand hygiene promotion program. In this before-and-after study, participants were staff members (n = 142) at two LTCFEs in Gunma Prefecture, Japan. We modified the World Health Organization's “five moments for hand hygiene” and assessed participants' hand hygiene adherence rates in four situations: (1) Before touching around a resident's mucous membrane area; (2) Before medical practice or clean/aseptic procedures; (3) After body fluid exposure/risk or after touching around a resident's mucous membrane area; and (4) After touching a resident's contaminated environments. The study was divided into four phases. In Phase 1, participants self-assessed their hand hygiene adherence using a questionnaire. In Phase 2, we objectively assessed participants' pre-intervention adherence rates. In Phase 3, an intervention comprising various hand hygiene promotion measures, such as education and hands-on training on hand hygiene practices and timings, was implemented. In Phase 4, participants' post-intervention adherence rates were objectively measured. Although most participants reported high hand hygiene adherence rate in the self-assessment (93.1%), the pre-intervention evaluation revealed otherwise (16.8%). Participants’ post-intervention adherence rates increased for all four situations (77.3%). The intervention program helped increase participants’ hand hygiene adherence rates, indicating its effectiveness. Similar interventions in other LTCFEs may also improve adherence rates.